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Toddler Sleep Journal and Plan

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G is back to sleeping horrifically... HORRIFICALLY... so I decided I needed a plan of attack. It really bothers me how he can do well for a ...

G is back to sleeping horrifically... HORRIFICALLY... so I decided I needed a plan of attack. It really bothers me how he can do well for a while, then revert to poor sleeping habits again. He's currently waking and having difficulty getting back to sleep 3+ times per night. We're pretty sure some of that is due to difficulty with sensory regulation (aka self soothing), but the weighted blanket hasn't quite done the trick.

I decided to start keeping a sleep journal just to track what is going on, then try to add things in that might help to see where we see a difference.

Here's a link to the sleep journal I created for him. I wanted to track food and exercise, as well as take notes on our day activities.

I also developed a list of sleep rules to post on our refrigerator. These are things I've looked up that are helpful to supporting melatonin increases (which promotes sleep). This is a link to the list if you want to print it out for yourself (it's nothing particularly attractive), but here's the list:

No TV or screen time (phones, video games, etc) for 2 hours prior to bedtime.

If it’s sunny out near to bedtime, no going outside 1-2 hours prior to bedtime.

Dim lights in the house and areas we are in approximately 1-2 hours prior to bedtime.

Play classical music, or have quiet time in the 1 hour before bed. No stimulating activities.

We were allowing TV/screen time before bed before because he gets so stimulated by non screen time activities that we were concerned that screen time might be a BETTER option. But the research says no screen time is better so we're going to give it a go. The one thing we may experiment with taking out is a bath before bed. It's fairly stimulating for him so we want to make sure that it's not hurting our bedtime routine; before we do that though, we're going to try turning more lights off in the bathroom during bedtime because the bright lighting may be inhibiting melatonin production. I am anticipating melatonin may be the key to why it's taking him so long to get to sleep. Once we put him in bed and turn the lights in his room off, it's taking 1-2 hours for him to fall asleep which suggests that it's taking that long for the melatonin to kick in after lights are out. We've tried changing bedtimes to see if that helps, but it doesn't seem to be the key... in fact, later bedtimes cause disastrously early wake ups AND still require 1-2 hours before he falls asleep. So he ends up sleeping 9pm until 6am. Not cool. The only benefit I see to the later bedtime right now is that it's darker out so stimulating the melatonin increase is easier and may happen without as much intervention from us.

I've had a few people suggest trying melatonin as a medicine, but I'm not comfortable with the amount of research available on whether it's safe for babies and toddlers. Here is a link from Livestrong about the use of Melatonin in toddlers. My personal thought about things that are in our body is that we should always exhaust ways to increase those chemicals and vitamins naturally before we resort to medications. Ie. If we're suffering symptoms of low Vitamin D, then get out in the sun. If we are low on a particular vitamin, then we should eat foods rich in that vitamin. Of course, if you have severe symptoms you do want to take medications, but I think you get my general idea. My understanding is that some foods increase melatonin presence with pineapple being the most, then bananas; the post I read wasn't clear as to the quantities required to actually see a benefit so I'm not sure if it will be helpful, but G loves fruits so it shouldn't be hard to start giving him fruit at dinner to see if it assists us at all.

My plan of attack is:

Keep a sleep journal for 1-2 weeks.

Begin to implement the sleep rules to see if those help.

If sleep problems continue and there are still indications of G having reflux still, we will try the dose of Zantac that the pediatrician prescribed. He had terrible reflux previously, but the best way to see if he's still got it is apparently to see if the medication helps (short of doing invasive procedures). If it works, great. If not, we'll take him off from it as we don't want to use unnecessary medications... and move on to step 3.

Implement any sensory techniques recommended by the Occupational Therapist to see if they help... so far we're not winning in that respect, but we haven't had much time with the OT yet.

Request that a sleep study be performed to rule out any sleep problems.

At the time of this posting, we are on Stage 3 with using Zantac and it's definitely helped reduce the number of night wakings and the amount of time it takes to go back to sleep once he wakes. He's still taking quite a while to go down to bed, however. We've got an appointment to discuss a sleep study that's at the end of June (there's only one place in Maryland that does them so the wait was quite long).